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Dye Localization Extended Segmentectomy vs. Lobectomy for Deep Intersegmental Early-Stage Lung Cancer
Wen-Yao Lee1,2, Ting-Fang Kuo3,4, Hsiao-Hung Lu5
1Graduate Institute of Pathology, National Taiwan University College of Medicine, Taipei 100233, Taiwan.
Diagnostics (Basel, Switzerland)
|March 14, 2026
Summary
Computed tomography-guided dye localization for extended segmentectomy offers better perioperative and lung function outcomes compared to lobectomy for early-stage lung cancer. This technique provides comparable oncologic control, making it a viable alternative for selected patients.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Deep intersegmental early-stage lung cancers pose challenges for complete resection.
- Computed tomography (CT)-guided dye localization enables precise identification of tumor margins for extended segmentectomy.
- Lobectomy is a standard treatment, but associated with greater lung volume loss.
Purpose of the Study:
- To compare perioperative and long-term outcomes of CT-guided dye localization extended segmentectomy versus lobectomy for early-stage lung adenocarcinoma.
- To assess the oncologic efficacy and functional impact of both surgical approaches.
Main Methods:
- Retrospective review of early-stage lung adenocarcinoma patients (≤ 2 cm) undergoing CT-guided dye localization extended segmentectomy (2013-2019) or lobectomy (2011-2016).
- 1:1 propensity score matching created 30 pairs for analysis based on demographic and clinical variables.
- Outcomes analyzed included operative time, blood loss, hospital stay, lung volume reduction, margin status, lymph node yield, and survival rates.
Main Results:
- Extended segmentectomy showed significantly shorter operative time, less blood loss, shorter chest tube duration, and reduced hospital stay compared to lobectomy.
- Patients undergoing segmentectomy experienced significantly less ipsilateral and total lung volume reduction at 6 months.
- All patients achieved negative resection margins; 5-year overall and disease-free survival rates were comparable between groups, despite lower lymph node yield in the segmentectomy group.
Conclusions:
- CT-guided dye localization extended segmentectomy is a safe and effective procedure for selected patients with deep intersegmental early-stage lung adenocarcinoma.
- This technique offers improved perioperative and functional outcomes with oncologic results comparable to lobectomy.
- Extended segmentectomy represents a promising alternative to lobectomy, preserving lung function while maintaining oncologic control.
